The fact remains that no matter how widespread HSA's become, or how efficient people claim HMO's to be, if people can't afford health care in the U.S., they can't get it. That number right now is floating between 35 and 45 million people, depending on which study you buy in to. So far I've yet to see anyone who is coming to the defense of private health-care address actually getting these people, who have NO money for health care; insured.

You are getting into the lower class who cannot afford health insurance. I allready addressed that issue.

A Government-run healthcare system will bankrupt the the United States. This is for two reasons:
1) Because it is the government and not the people who are paying for healthcare...doctors, hospitals, and drug manufacturers can charge whatever the hell they want. I mean, the people are not paying for it. So who cares if the government has to fit the bill?

2) This would add a huge increase in federal entitlement spending. I believe entitlement spending is about 50%+. Adding healthcare will leave absolutely no room for discretionary spending and no room to pay off the debt because the net interest will continue to expand.

Because the government is sent the bills...they will be forced to increase taxes which will not benefit ANYONE. Because the people may have their "sub-par" healthcare...but they will still be strapped for cash because of the huge amounts of taxes.

In order to allow people to afford healthcare...you have to cut taxes. Let the people keep more of the money in which they have earned. Then they will be able to afford private healthcare.

As has been repeated ad nauseum in other threads, the people who have little or no income (who are the same people who by-and-large can't afford health care) pay little or no taxes. Reducing taxes would have ZERO effect on their ability to find private insurance. None whatsoever.

First, if they pay little or no taxes...doesnt that kind of prove my theory the government will go bankrupt if they provide universal healthcare? It would be the same situation as we have no with Social Security...people taking out more than they put in. And to your comment...raising taxes definately wont help people afford insurance...so while it may be improbable that reducing taxes will bring about a positive effect...it is more likely.

We must adhere to the Trickle Down Economy used by Reagan and both Bushs. Cut taxes across the board...income, corporate, exc...

This will create more profit margins for corporations. What will the big-wigs do with this money? Invest it in their own company to make even more money. This will create new jobs and increase production. When more people have jobs...more people pay taxes which helps the economy. Also, with tax cuts the people will spend more money and an economy that is 80%+ Consumer driven...that is a good thing.

What this means is that if we lower taxes for everyone...not only will middle class and lower income families have a more probable chance at affording health coverage...but the increased production of prescription drugs will drive prices down.

As i already addressed, adding more entitlement spending to our federal budget is just not in our best interest.

While that may be true for certian government related health care programs, it's not always the case.

Im using Canada's system as an example. It is not profit driven, that cut's out the majority of fraud that currently plagues medi-care. The government control's the cost.

http://www.healthcoalition.ca/factsheets/M...reNewsflyer.PDF

http://www.hc-sc.gc.ca/english/about/acts_regulations.html

Yes but price fixing brings up the question of Research and Devlopment and the collapse of the market economy for drugs. If the government controls prices...no new drugs can be researched and thus no new cures for diseases. NO Stem Cell Research...NO cure for Cancer...none of it will ever be possible because the drug companies will not have the extra money to do it. That is why drugs and healthcare cost so much and why it is cheaper in other countries. They just take our drugs and sell them at a cheaper price.

And a non profit-driven economy is in conflict with our current capitalist system. Profit makes the jobs, creates the drugs and helps the economy.

Why can manufacturers charge whatever they want? Because Congress took the White House's word on the actual cost of the Medicare reform bill and a proposal that "would've allowed pharmacists and wholesalers to 'reimport' brand-name drugs from Canada, where they are cheaper" was omitted from the final version so decent folk like Billy Tauzin could get a better job? Strange how it is ethical for some institutions to demand discounts but when the average American citizen asks why they have to pay three times as much as foreigners for the same brand he's told he should be lucky to have the best healthcare in the world.

Don't forget. Best healtcare in the world.

Look, your absolutely right. Its not fair that Americans have to pay more for their drugs. But the reason has been stated. R&D costs are the reason that Americans pay so much. Other countries take our drugs and sell them at a way cheaper price. If Americans started buying their drugs from other countries then there would be no money for R&D and NO NEW DRUGS WOULD BE CREATED. Then, in order to compete, American companies will have to drop their R&D which benefits nobody because other countries do not commit to R&D. Thats why the famous people in Canada come to the United States for major treatment.

I agree with your sentiment but you are exaggerating a bit. The Canadians and Europeans do have lower cost's because we pay the bill and if we adopted UHC they can expect their prices to increase and US research to decrease. There's no way to calculate what the impact would be.

The research market would not "collapse" but it would suffer.



Which brings us to the problem's that arise from price control. The problem with our current health care system is that it sheilds the cost from the doctor and patient in which I have allready explained this in detail if you review my post just after bigfish's post.

Edited to remove dirt at the bottom of the ocean reference.

If we dont find a way to allow for people in america to reach healthcare, that means many people may die or live sick and in pain all the time. I think one could compare such to the birth control policy in china in terms of the government being barbaric towards its people for some reason. The other aspect of it all is where do the resources come from and who is going to spend the energy and or money. It may also breach the general welfare clause as to let americans die in light of the fact such can be stopped, but i am sure this already happens, heck various stories of religious people not allowing for children to get medical attention still exist, so i dont know exactly what kind of a perception you can get with this in terms of people, but it could be very easy that someone could say no medical attention unless you can cover the bloated costs of such. I do agree that some form of medical attention should always be able to be obtained, and that emergency room medicine is not a option on the top of the list in terms of many factors(xi-factor was a good comic book), but that other forms of medical care provided are better then such.

The system of america, in terms of economy and its relation to the tax system and or people in general is a vastly complex and dynamic life form to say the least. I fear mistakes and or pitfalls can easily arise in a quick fix or some other option that is not thought out very well. How does a tax credit work, is it enough money for even one individual, or a family, and what then happens to tax money that goes to infrastructure currently existing, like education, roads or the military, all which cost a lot. Again its complex, and of course growing population in a segregated humanity or even america is not going to help the issue get any better. I opt to make drugs legal and regulated, being the war does not stop them. Then we can use that money to pay for things, being people use the drugs anyways, and we can stop wasting money on that endeavor or reason to get into other countries and make police states. it would also cut down on people coming across the border for various reasons and undercut terrorist funding, but i dont know what the poor would do for money in many situations. its a win win situation overall though, it could easily pay for medical care, but its not a norm type of thought to do such. We could also switch to hydrogen fuel, which could clean our environment up, become the main source of energy, cutting down how much we have to spend overseas, from time and money to people and such, this money could also go to pay for medical care, and other. Again, i dont think the stagnent and failed policys of yesterday revamped will fix such an issue, not in light of the reality and size of scope of the problem.

Let's clear up a couple of misconceptions here. First, other countries don't "take" our drugs, and then just sell them at a cheaper price. They negotiate with the drug companies for cheaper, bulk purchasing costs to begin with. Do you really believe that the drug companies are selling drugs to Canada and the UK at a loss?

Yet, in the new drug prescription plan for seniors, Medicare was specifically forbidden to do the same thing. They are required to pay whatever the drug company wants to charge. Why is that?

Next, I would argue that the "R&D costs so much", that lower drug profits would lead to less R&D and no new drugs, is a bogus argument.

First, drug industry R&D cannot possibly be as risky as companies claim. In every year since 1982, the drug industry has been the most profitable in the United States, according to Fortune magazine’s rankings. During this time, the drug industry’s returns on revenue (profit as a percent of sales) have averaged about three times the average for all other industries represented in the Fortune 500. In fact, in 2000, the top ten pharmaceutical companies on the forbes 500, had greater profits than the other 490 companies combined. It defies logic that R&D investments are highly risky if the industry is consistently so profitable and returns on investments are so high.

Second, the reason that it's not nearly as risky for these companies as they want you to believe?

Most of the research into new drugs is already being financed by taxpayers in this country, either through the NIH (National Institute of Health), or through government grants and research facilities at publicly funded universities, military hospitals, and the like. And government funded medical R&D typically focuses on the early stages of a drug's development, when the risks are the highest. For many drugs, the government has paid for most or all of the pre-clinical research, and it frequently funds the development of the drug all the way through FDA Phase II and Phase III trials.

If, for example, the government has funded the pre-clinical research, then two-thirds of the cost of developing a new drug has already been paid for. And if the drug company obtains the rights to the drug after the conclusion of Phase II trials, more than 84 percent of the development costs are already accounted for. After Phase III trials, 96% of the costs are accounted for. So, where is the exhorbitant cost to the company, for the risk of failure in researching a drug, when they are only paying anywhere from 4% to 16% of the research cost?

In these cases, the drug should be priced to reflect the decided lack of risk taken by the company for the development of the drug. Yet, when they get all of this research, up to and including, in many cases, the actual formulation of the product, courtesy of the government research, they are allowed to patent it, and profit from it as though they had done all the work themselves, and born all the risks.

So citizens of this country are being asked to pay for these drugs twice. Once through tax revenues, and again through exhorbitant prices, due to patents on drugs that should have been public domain, or at least patent limited, due to taxpayer funded research.

Prescription drug costs are fast approaching the total cost of physician visits. How much of our medical costs could we save in this country, on prescription drugs alone, if we limited the patent time to a percentage of the full seventeen years, based on the percentage of actual risk taken on by the company?

R&D certainly adds to the cost, but maybe not as much as one might think. Knowing that the government also funds some medical research, a quick search turned up these two links: first, this one, which claims that the government spends $28 billion of taxpayer money each year for research; the second link says that American pharmaceutical companies spent $32 billion in 2002 on the research. So, we as taxpayers are already funding close to half.

I voted "yes" for UHC. For reasons outlined in the many previous posts. Seems to me we should be able to look over other countries' plans and pick and choose which parts would work best for us, and in the process avoid the problems other countries have run into. But in the meantime, the problem of uninsured Americans continues to worsen. If something isn't done soon, eventually it will be too late and the whole house of cards could collapse. At some critical point, maybe when the number of uninsured Americans exceeds the number of insured, it's got to crash. I'd think, anyway.

edited to add: oops, I cross-posted with niteguy and covered many of the same points. Sorry for the redundancy, folks.

A higher profit return normally means a higher risk factor. That's why new technologies bring in higher profit's because they are riskier.



If my industry only accounts for 2.5% of the total domestic sales but my R&D budget account's for 8.7% of all company-funded R&D, that means my profit margin from those sale's must be higher than other industries if I want to survive. That also means my industry is riskier because I have to research more in order to make that money back. Once you control that cost the companies will take a large hit on profits. So what will that mean for R&D and new medicine that is primarily developed by US pharmaceutical companies? This is exactly why adopting a single-payer system in the US, or even price controls, will cause a steep decline in R&D. Do you believe those companies would survive by selling their drugs at the same prices they do in the rest of the world in the US? The only reason they are able to maintain a large percentage of money in R&D is because they make a higher profit margin. Once you cut off that profit margin with government controlled prices then your basically asking them to cut back spending dramatically. Of course prices have gotten out of control, but government controlled prices is not the answer, bringing transparency to the market is.







OK, so your statement in bold is obviously false even if you wanted to include state and local government contributions. 21% of the R&D is spent on existing medicine. 79% of the time they take a large risk factor because it's yet to be known to produce results. The government primarily researches basic medical science, meaning the pharmaceutical companies do take a large risk when they venture into the unknown, costing them millions, which is why they have to maintain a higher profit margin when they do strike gold.

It's not that I doubt your veracity, Vampiel, but I do, however doubt the veracity of the links you provided. For instance, let's look at the two WebMD sources you cite. I noticed something at the bottom of each of the pages you linked to. That something is this:


C'mon Vamp. A PR piece by a pharmaceutical company (GlaxoKline) can hardly be considered objective, now can it?

One of the cited pages even admits to something I said, but they use it as a "throwaway" line, in a larger paragraph. My quoted statement:

And now the quote from the WebMD page. Notice how unimportant they make that early research and development seem:

Hmm, most of the government's research is in the early stages, where the highest rates of risk and failure occur. Isn't that exactly what I said? So again, I ask, if the government is taking on most of the high risk research, why is it that a private company gets to keep all of the reward as if they were taking the risk?

Also, I find this statement in the same article more than a little misleading:

The fact is, this isn't accurate at all. According to Public Citizen's Congress Watch report, the NIH examined, in 1995, the top 5 selling drugs. Before looking at these drugs, the NIH had no idea what role public funding of research played in the development of these drugs. Their findings?

Ok, Vamp, here's my big (sort-of) apology. I may be wrong. If big pharma's numbers are to be believed, they do indeed spend more in research than the government. But not that much more. If you do indeed include from your "Research America" link, the state, local, university and independent research institutes (which undoubtably receive government funding), drug companies spend $49,900,000 on research. All of the government spending, including the states, universities, etc, but not including the private foundations, comes to $40,821,000 a difference of less than $10 million. If that's indeed the case, public funding isn't most of the R&D in this country, but it's still a significant amount, isn't it?

But, can big pharma's numbers be believed? Critics have long maintained that drug companies include in their published research numbers, expenses that should more accurately be included in the marketing and/or operations numbers, to inflate their research numbers as a scare tactic ("No new drugs would be made if it weren't for our R&D sacrifice").
source: Public Citizen.org http://www.citizen.org/documents/ACFDC.PDF

And if you think that the pharmaceutical companies perform more research in the form of clinical trials than the government or other public agencies, you'd be wrong again. According to the governments own website, that keeps track of current and ongoing clinical trials, both those recruiting test subjects and those that don't, the numbers heavily favor the public sector.

For recruiting trials only, drug companies are funding 940 trials. But the public sector is funding 5095 trials. Non-recruiting trials are even more telling: 2,730 drug company trials, compared with 13,541 public funded trials.

The fact is, the public is financing a huge portion of medical research in this country, and then we're getting stuck with the tab on the other side, as well, by paying more for the drugs here than anywhere else in the world. I think it's about time we started seeing some "return" on our investment.

No not lower costs for better coverage. More realistic use of health care when we spend our own money. If you tell me to go pick out a product, anyone, I'll pick the one of the absolute highest quality along with a few style perks that seem cool. When you tell me that costs five times one that meets all of my quality needs but isn't custom made or quite the very best it won't matter to me until it costs me something. So when we have insurance we want the upper limits of our coverage or we never bother to look at the costs unless they actually land in our pockets in a substantial way (i.e. not a $5 copay for a $300 doctor visit)




Quote #1. Let's not forget that the uninsured in this country are not really uninsured. When they are in need of medical attention they are not turned away from our hospital. I'm sure there are anecdotes to the contrary and hospitals that conspire to get around these costs be rerouting ambulance and the like, but . . . Those 44 million people will get their care. So where to the costs go......? They land in the costs of running a hospital and show up in the medical bills that are actually paid for the hospital. Also since the care tends to be emergency care it is of higher cost. So these costs are a big part of why our overall health costs are rising.


Quote #2. People want something for nothing. Ahhh the bane of our public policy. This is the same theory that pushed for tax cuts without any realistic way to pay for them but vague assurances. Politicians want to give something to constituents whether it be tax cuts, service improvements or both. And they should be stopped.
But I think we need to go to a hybrid system that has government involvement. If the UHC systems lead to doctor shortages, we should pay(loan) for doctors training and get doctors on salary and have incentives for working for their government that help wipe out that med school debt.

Those high administrative costs Amlord referred to are fat in the system that can be weened out. I government minimum health package that is set out in the market to compete with other systems and purchased by individuals would be a much more preferable system to me that having these systems tied to employment. Market incentives and strong government oversight. The government does not always do these things poorly and the inefficient system that exists today is in need of an intervention. Deregulation and unregulation are not always the better systems.